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Importancia de los márgenes quirúrgicos afectados en la conización uterina cervical.

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Title: Importancia de los márgenes quirúrgicos afectados en la conización uterina cervical.
Alternate Title: Importance of surgical margins affected in cervical uterine conization.
Authors: Santa María-Ortiz, Johana1, Álvarez-Silvares, Esther2 esther.alvarez.s@gmail.com, Bermúdez-González, Mónica1, García Lavandeira, Sandra3, Pato Mosquera, Mónica3, Couso Cambeiro, Bárbara3
Source: Ginecología y Obstetricia de México. Sep2020, Vol. 88 Issue 9, p586-597. 12p.
Subjects: CERVICAL intraepithelial neoplasia, UTERINE cervix incompetence, PAPILLOMAVIRUSES, HUMAN papillomavirus vaccines, DISEASE relapse, CONTRACEPTION, CONDOM use, CONIZATION
Abstract (English): OBJECTIVE: To determine the association between affected margins with persistencerecurrence of cervical intraepithelial neoplasia, persistence of human papillomavirus and re-interventions. MATERIALS AND METHODS: Study of cases and controls nested in a retrospective cohort of the Complexo Hospitalario Universitario de Ourense (January 2010-October 2017). Inclusion criteria: women with at least one post-intervention check-up. Exclusion criteria: women without evidence of high-grade dysplasia in the conization piece and who were not followed up. Study variables: age, smoking, condom, oral contraceptives, HPV vaccination, persistence-recurrence of CIN and HPV, and re-operation. Parametric and non-parametric tests were performed among the variables. RESULTS: The cohort consisted of 248 women, 81 of whom (32.6%) had affected surgical margins on conization. Immunosuppression, smoking and oral contraception were the most frequent associations in affected margins. Condom use and HPV vaccination were significantly more frequent in free margins. Affected margins reported greater persistence of HPV (50 vs 23.9%; OR 3.17 (1.90-5.26), p < 0.001), persistent-recurrent disease (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p < 0.001), and reinterventions (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p < 0.028). The most affected margin was, in descending order, endocervical (55.6%), exocervical (25%) and both (19.4%). CONCLUSIONS: The affected margin confers a significant risk in the evolution of HPV infection and disease recurrence. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): OBJETIVO: Determinar la asociación entre los márgenes afectados con la persistenciarecurrencia de neoplasia intraepitelial cervical, persistencia del virus del papiloma humano y las reintervenciones. MATERIALES Y MÉTODOS: Estudio de casos y controles anidado en una cohorte retrospectiva del Complexo Hospitalario Universitario de Ourense (enero 2010-octubre 2017). Criterio de inclusión: mujeres con al menos una revisión postintervención. Criterios de exclusión: mujeres sin evidencia de displasia de alto grado en la pieza de conización y a las que no se dio seguimiento. Variables de estudio: edad, tabaquismo, preservativo, anticonceptivos orales, vacunación contra VPH, persistencia-recurrencia de NIC y de VPH y reintervención. Se realizaron pruebas paramétricas y no paramétricas entre las variables. RESULTADOS: La cohorte se integró con 248 mujeres, de éstas 81 (32.6%) tuvieron afectación de los márgenes quirúrgicos en la conización. La inmunosupresión, el tabaquismo y la anticoncepción oral fueron las asociaciones más frecuentes en los márgenes afectados. El uso de preservativo y la vacunación contra VPH fueron significativamente más frecuentes en los márgenes libres. Los márgenes afectados reportaron mayor persistencia de VPH (50 vs 23.9%; OR 3.17 (1.90-5.26), p < 0.001), enfermedad persistente-recurrente (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p < 0.001) y reintervenciones (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p < 0.028). El margen más afectado fue, en orden descendente, endocervical (55.6%), exocervical (25%) y ambos (19.4%). CONCLUSIONES: El margen afectado confiere un riesgo importante en la evolución de la infección por VPH y la recurrencia de la enfermedad. [ABSTRACT FROM AUTHOR]
Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
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  Data: Importancia de los m&#225;rgenes quir&#250;rgicos afectados en la conizaci&#243;n uterina cervical.
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  Data: Importance of surgical margins affected in cervical uterine conization.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Santa+Mar&#237;a-Ortiz%2C+Johana%22&quot;&gt;Santa Mar&#237;a-Ortiz, Johana&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22&#193;lvarez-Silvares%2C+Esther%22&quot;&gt;&#193;lvarez-Silvares, Esther&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;i&gt; esther.alvarez.s@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Berm&#250;dez-Gonz&#225;lez%2C+M&#243;nica%22&quot;&gt;Berm&#250;dez-Gonz&#225;lez, M&#243;nica&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Garc&#237;a+Lavandeira%2C+Sandra%22&quot;&gt;Garc&#237;a Lavandeira, Sandra&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pato+Mosquera%2C+M&#243;nica%22&quot;&gt;Pato Mosquera, M&#243;nica&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Couso+Cambeiro%2C+B&#225;rbara%22&quot;&gt;Couso Cambeiro, B&#225;rbara&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CERVICAL+intraepithelial+neoplasia%22&quot;&gt;CERVICAL intraepithelial neoplasia&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22UTERINE+cervix+incompetence%22&quot;&gt;UTERINE cervix incompetence&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22PAPILLOMAVIRUSES%22&quot;&gt;PAPILLOMAVIRUSES&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HUMAN+papillomavirus+vaccines%22&quot;&gt;HUMAN papillomavirus vaccines&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22DISEASE+relapse%22&quot;&gt;DISEASE relapse&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CONTRACEPTION%22&quot;&gt;CONTRACEPTION&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CONDOM+use%22&quot;&gt;CONDOM use&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CONIZATION%22&quot;&gt;CONIZATION&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: OBJECTIVE: To determine the association between affected margins with persistencerecurrence of cervical intraepithelial neoplasia, persistence of human papillomavirus and re-interventions. MATERIALS AND METHODS: Study of cases and controls nested in a retrospective cohort of the Complexo Hospitalario Universitario de Ourense (January 2010-October 2017). Inclusion criteria: women with at least one post-intervention check-up. Exclusion criteria: women without evidence of high-grade dysplasia in the conization piece and who were not followed up. Study variables: age, smoking, condom, oral contraceptives, HPV vaccination, persistence-recurrence of CIN and HPV, and re-operation. Parametric and non-parametric tests were performed among the variables. RESULTS: The cohort consisted of 248 women, 81 of whom (32.6%) had affected surgical margins on conization. Immunosuppression, smoking and oral contraception were the most frequent associations in affected margins. Condom use and HPV vaccination were significantly more frequent in free margins. Affected margins reported greater persistence of HPV (50 vs 23.9%; OR 3.17 (1.90-5.26), p &lt; 0.001), persistent-recurrent disease (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p &lt; 0.001), and reinterventions (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p &lt; 0.028). The most affected margin was, in descending order, endocervical (55.6%), exocervical (25%) and both (19.4%). CONCLUSIONS: The affected margin confers a significant risk in the evolution of HPV infection and disease recurrence. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: OBJETIVO: Determinar la asociaci&#243;n entre los m&#225;rgenes afectados con la persistenciarecurrencia de neoplasia intraepitelial cervical, persistencia del virus del papiloma humano y las reintervenciones. MATERIALES Y M&#201;TODOS: Estudio de casos y controles anidado en una cohorte retrospectiva del Complexo Hospitalario Universitario de Ourense (enero 2010-octubre 2017). Criterio de inclusi&#243;n: mujeres con al menos una revisi&#243;n postintervenci&#243;n. Criterios de exclusi&#243;n: mujeres sin evidencia de displasia de alto grado en la pieza de conizaci&#243;n y a las que no se dio seguimiento. Variables de estudio: edad, tabaquismo, preservativo, anticonceptivos orales, vacunaci&#243;n contra VPH, persistencia-recurrencia de NIC y de VPH y reintervenci&#243;n. Se realizaron pruebas param&#233;tricas y no param&#233;tricas entre las variables. RESULTADOS: La cohorte se integr&#243; con 248 mujeres, de &#233;stas 81 (32.6%) tuvieron afectaci&#243;n de los m&#225;rgenes quir&#250;rgicos en la conizaci&#243;n. La inmunosupresi&#243;n, el tabaquismo y la anticoncepci&#243;n oral fueron las asociaciones m&#225;s frecuentes en los m&#225;rgenes afectados. El uso de preservativo y la vacunaci&#243;n contra VPH fueron significativamente m&#225;s frecuentes en los m&#225;rgenes libres. Los m&#225;rgenes afectados reportaron mayor persistencia de VPH (50 vs 23.9%; OR 3.17 (1.90-5.26), p &lt; 0.001), enfermedad persistente-recurrente (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p &lt; 0.001) y reintervenciones (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p &lt; 0.028). El margen m&#225;s afectado fue, en orden descendente, endocervical (55.6%), exocervical (25%) y ambos (19.4%). CONCLUSIONES: El margen afectado confiere un riesgo importante en la evoluci&#243;n de la infecci&#243;n por VPH y la recurrencia de la enfermedad. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Ginecolog&#237;a y Obstetricia de M&#233;xico is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.24245/gom.v88i9.4317
    Languages:
      – Code: spa
        Text: Spanish
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      Pagination:
        PageCount: 12
        StartPage: 586
    Subjects:
      – SubjectFull: CERVICAL intraepithelial neoplasia
        Type: general
      – SubjectFull: UTERINE cervix incompetence
        Type: general
      – SubjectFull: PAPILLOMAVIRUSES
        Type: general
      – SubjectFull: HUMAN papillomavirus vaccines
        Type: general
      – SubjectFull: DISEASE relapse
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      – SubjectFull: CONTRACEPTION
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      – SubjectFull: CONDOM use
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      – SubjectFull: CONIZATION
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      – TitleFull: Importancia de los márgenes quirúrgicos afectados en la conización uterina cervical.
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              M: 09
              Text: Sep2020
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